Cytological evaluation correlates poorly with histological diagnosis of vulvar neoplasias.

OBJECTIVE

To determine whether cytological smears of the vulva correlate with vulvar biopsies of vulvar intraepithelial neoplasias (VINs).

MATERIALS AND

METHODS

A retrospective chart review (1995-2000) was performed to identify cases of VIN and vulvar carcinoma and to correlate vulvar Pap smears with biopsy results.

RESULTS

Four hundred vulvar Pap smears were identified. Fifty of these patients had concomitant vulvar biopsies, and these cases constitute our study group. Twenty-two of these 50 women had biopsy-proven VIN or vulvar carcinoma. Only 7 (32%) of 22 patients with biopsy-proven disease had a vulvar Pap smear significant for VIN or vulvar carcinoma. The kappa statistic was 0.30 (95% CI=0.08-0.52), indicating poor agreement between vulvar cytology and biopsy results.

CONCLUSIONS

Vulvar cytological evaluation did not correlate well with tissue diagnosis of VIN; and thus, our findings do not support the use of vulvar cytology in the clinical management of VIN.